Do you discuss health care costs with your doctor?

How fast can you schedule surgery or an MRI in the U.S.? IME neither is immediate (actually I can’t do an MRI because I have a metal plate in my leg now, but the CT wasn’t instantaneous either). I live in a major city and it normally takes at least a couple of weeks to do either thing on a nonemergency basis. The wait for an initial outpatient consultation with any specialist I’ve ever seen is also generally at least a couple of weeks, sometimes up to 6 weeks. And I have good insurance, so that’s not the issue.

I’m also from the UK- sorry for the minor hijack, but as I don’t talk to my doctor about health care costs, I’ll just talk to you guys.

Generally you need an appointment, normally it’s booked the same day with my doctor, though I’ve never not been able to get one when it’s been urgent. There is also an out of hours service which is open 24 hours in my area, 7 days a week, plus a drop in centre for really minor stuff. If you live in a reasonably large town, you can see a doctor the same day, even if it’s not worth going to A & E (as we call the ER). You might not be able to pick your doctor though.

Incidently, the £8.05 prescription charge is a maximum, you can also get a prepayment card which is £104 for all medications for a year, or they’re free in many circumstances.

Scans and suchlike are triaged- when I had an MRI, the wait was several months, because it wasn’t for a serious condition (a herniated disc that was not at the time causing serious problems), but those with serious conditions don’t wait around. When my condition deteriorated, I was offered immediate surgery- as in, would you rather stay here or come back tomorrow morning. The official waiting list was 8-10 weeks at that point.

The wait time horror stories are for less time sensitive situations, aside from the occasional mix up, which sadly happens everywhere. People aren’t dying waiting 6 months for cancer treatment. They might be waiting 6 months for a knee op.

We do also have the option of ‘going private’, which is generally substantially cheaper than the same treatment in the US, from everything I’ve heard. Often the wait for a specialist diagnosis is the long bit, so it is possible to pay to see a private specialist then get referred back to the NHS for treatment.

Eyes are a bit odd, in that serious conditions are treated free (a friend had a detatching retina, picked up during a routine check-up, and had surgery within hours of diagnosis), but check ups (in England) and minor conditions are not. Generally you pay for glasses, but you can get them paid for if your eyesight is bad enough and not fixable. Cataract surgery is covered, but the waiting times can be quite long.

I’m not sure where you get the idea that people don’t come here from overseas for medical treatment from, but it’s quite common; there’s currently a lot of talk about trying to crack down on people from overseas taking advantage, as there’s often no ID checks. Emergency care is free to anyone regardless, but in theory there’s supposed to be charges for other stuff, however hospitals aren’t geared up for taking payments, and it often doesn’t happen.

The main reason I guess we don’t rave about our medical care more is that we just take it as normal. We kind of do though- see the 2012 Olympic opening ceremony for example.

It occurs to me that Gus may have meant laser-treatment to correct short-sightedness or some other regular wear and tear. That’s not generally covered, and needs to be paid out of pocket. But, yeah, something like a detached retina gets sorted on the NHS.

This. I didn’t answer the poll for that reason.

Well I wish we could have that with no one upset with the tax rate, like the rate in Holland, but if the government of England can provide equal service & quality on a government controlled salary, to the rest of the world, why does not the rest of the world do it?

It does not appear to me that the new government health care system here is going to be a step up for as many as a step down for most. IMO.

Who determines that you are OK to wait 6 months for knee surgery and do they give really adequate meds to allow you to wait that long & cover your salary for 6 months of not working because of your not very bad knee surgery as determined by them I suppose?

Or is that where the stiff upper lip part comes in? Sorry, just could not help myself on that one. :smiley:

Well, I guess my information is incorrect and socialized medicine is superior to any other system.

With our media, I really should have expected this. ::: grump ::::

They pretty much do.

Countries with Universal Health Care (details, of course, vary):
1 Africa
Rwanda[5]Algeria,[6] Egypt,[7] Ghana,[8] Libya,[9] Mauritius,[10] Morocco,[11] South Africa,[12] and Tunisia.[13]
2 Asia
2.1 Bhutan
2.2 Hong Kong
2.3 India
2.4 Israel
2.5 Macau
2.6 People’s Republic of China
2.7 Singapore
2.8 Taiwan
2.9 Thailand
3 Europe
3.1 Austria
3.2 Denmark
3.3 Finland
3.4 France
3.5 Germany
3.6 Greece
3.7 Guernsey / Jersey
3.8 Iceland
3.9 Ireland
3.10 Isle of Man
3.11 Italy
3.12 Luxembourg
3.13 Netherlands
3.14 Norway
3.15 Romania
3.16 Russia and Soviet Union
3.17 Serbia
3.18 Sweden
3.19 Switzerland
3.20 United Kingdom
3.20.1 England
3.20.2 Northern Ireland
3.20.3 Scotland
3.20.4 Wales
4 North America
4.1 Canada
4.2 Cuba
4.3 Mexico
4.4 Trinidad and Tobago
4.5 United States [Note, the entry for this one says, “The United States does not have a universal health care system,” so I have no idea why it’s on the list.]
5 South America
5.1 Argentina
5.2 Brazil
5.3 Chile
5.4 Colombia
5.5 Peru
6 Oceania
6.1 Australia
6.2 New Zealand

Pretty much.



If gasoline were $7 tomorrow, my eyes might bug out of my head a little bit, but I would still fill my tank because I am 100% reliant on petroleum to get to work to earn a living.

Medicine? Same deal, but infinitely more serious.

I did have my dental hygienist mention costs with me last week. She said “we have decided to add two steps to our standard cleaning. We will examine your mouth for signs of cancer with a (something) light and we will administer a flavorless colorless fluoride gel treatment. We will bill your insurance company $x and $y respectively, but if they refuse to pay the doctor will cover the cost.” Which is pretty cool.

And I go every 3 months for a cleaning and my insurance company gets huffy about the two extra visits per year and sends me a nasty letter refusing to pay. Whenever I try to settle up at my dentist’s office they never want my money.

I’m not trying to be a contrarian here, but I just can’t get past the notion that the US healthcare system offers such a perceived advantage versus Canada or the UK or other First World nations that offer universal healthcare coverage.

My family has excellent insurance coverage, by US standards. And, since December of 2012, most of my husband’s medical treatment has been 100% covered, because he’s being treated for injuries suffered on the job. The list of treatments he has received without a significant delay?

He had X-Rays and a CAT scan the day he was airlifted to the trauma center.
He had surgery to piece his ankle back together 24 hours later.
And he had an MRI 14 hours after it was ordered, while still hospitalized at the trauma center.

Everything else? Wait.
The insurance company has to approve everything first, and then the appointments must be scheduled. Tony waited four freaking days for everyone to get their ducks in a row so that he could get a PICC line for IV antibiotics when he developed MRSA and enterobacter infections that nearly cost him his leg and/or life. It was a full week before everyone agreed that a man with a cast, 23 rods and screws in his ankle, two SLAP tears and a torn rotator cuff, a torn miniscus in his “good” knee, a cracked pelvis, four spinal fractures, three broken ribs, and a labral tear in the hip could have a GD wheelchair (after two weeks in the hospital and another in rehab.)
And even before the wreck, when Tony was having serious degenerative knee problems, it was over a year of waiting, paying co-pays for stopgap treatments, scheduling imaging, etc., before Tony could have knee surgery.
When we moved to a new city and had to change pediatricians, it took many phone calls to find a practice that was accepting new patients AND accepted our health insurance.
When I sprained my ankle and broke my foot at work, in 2010, the best the workers comp insurance could do was to make me an orthopedics appointments two weeks after the injury. During those two weeks, I was supposed to “just stay off of it.” Fortunately, I already owned a walking cast, because I had a baby and two bigger kids and there’s no “just stay off of it” when taking care of kids. And my husband’s ortho took pity on me, and convinced the insurance to cover it when his practice saw me in one week, versus two. I had a grade 3 sprain, plus a couple of broken bones.
And speaking of that baby? I couldn’t use my regular OB/GYN for prenatal care, because the insurance company no longer had her on The List. Nothing like searching for a new obstetrician as a 40-year-old expectant mother!

My father is diabetic, with congestive heart failure. His insurance is reasonably good. He waits for treatment, because he lives in a rural area with a shortage of practitioners. Sometimes he can’t afford his treatment. Some of his treatment is at the VA, so he drives 120 miles each way, waits for hours, etc. And does it again when he needs any sort of diagnostic testing or imaging. And usually again to get his results.

My grandmother is 89 years old, and in a nursing home attached to a hospital. She waited two days for a hip x-ray. And another three days before someone could read it properly and diagnose her with a broken hip. (Yes, I know that humans are, after all, humans. But when an 80-something woman falls out of bed onto a hard tile floor, and complains of excruciating hip pain? You probably want to double-check that film before concluding that the hip isn’t broken.) Before going to the nursing home, it took about four months to schedule Grandmother’s cataract surgery. It was always about a 2-week wait to get an appointment with her gerontologist.

This system isn’t the paradise that the pundits seem to think it is…

Sorry about the hijack…

I chose “other” in the poll. I try to discuss costs and treatment options. Most doctors aren’t overly aware of the costs of lab tests, imaging, and so forth. So mostly, I don’t go to the doctor unless it’s something obviously dire.

I’m still paying off the cost of the ER visit when my daughter fell and bashed her face and mouth. $150 ER co-pay up front, plus almost $1000 that the insurance didn’t cover.


Your Doctor decides, based on medical need. If it is really bad then you go to the head of the line and get it done ASAP.
And yes, they give you adequate meds and if you are incapacitated and can’t work then you will receive income either from your company (this will be a contractual obligation and the amount and length varies) or from one of the various welfare schemes.

Yes, it certainly seems to be.

Remember, we cover everyone, for pretty much everything, no co-pay, no yearly or lifetime limits, no exclusions, no insurance red-tape. And it costs the UK public purse less per capita than the USA spends per capita. I can also pay to go private should I not want to wait at all (but that still costs me less than an equivalent USA policy…and I have the NHS as back-up)

So it is a great system, not perfect, but pretty damn good. It takes substantial political will to push it through and I don’t see you having that will in the USA any time soon. Hopefully the ACA will be the thin end of a very benevolent wedge.

I always ask doctors about cost and they always act as if I am asking extremely personal questions about their sex life or something. They give every indication that I am being rude: wrinkled nose, pursed lips, vague answers. Yet I press on. They’d really rather pretend everything is paid for from a magical money tree.

In the last six years, I have changed from good insurance to no insurance to crap insurance to no insurance and now have good insurance again. I always choose to have an FSA account when it’s offered by my employer, because my daily finances run so tight that an unexpected trip to the doctor can mess me up.

When I had no insurance, I went to a charity clinic where they automatically took cost into account. I doubt they ever prescribed anything that was not a generic. What killed me was that I couldn’t hold down a job because I was a) clinically depressed and b) taking care of my father, but I didn’t qualify for any government aid because I was a grown woman with no children. If I’d had kids, I could have qualified for Medicaid. If I’d been 65 or older, I’d have qualified for Medicare.

I still, even with a gold plan from BCBS, discuss costs with my doctor. Why? Because I consider it part of my job to both protect myself from over-treatment and to keep treatment costs as low as possible for what I do receive. However, I haven’t been hospitalized or gone for any reason in more than 15 years or gone to the ER in the last six years. I think that would be exponentially more difficult to keep costs down and fully expect to have to declare bankruptcy if I ever have a serious illness or complicated injury.

LASIK and similar procedures aren’t covered by health insurance here, either. My employer offers “vision insurance” which purports to cover LASIK, meaning I can have both eyes done for about $4,000 - or pretty much the same as the entire uninsured out-of-pocket cost if I shopped around a little. :smack:

I did this morning, in a routine visit with my cardiologist. I asked him if they were raising his rent, and he replied that he is employed by the hospital, so the office space is a perk, which is in a separate building owned by the hospital.

The reason I asked was because my GP is in private practice in the same building and complained that his rent was being raised so much, he was planning on moving to a new location. I told him to just raise his fees, and he said he can’t – Medicare and private sector insurers cap what he can charge for each visit and procedure.

Since I’m on medicare, the only doctors I can negotiate with are dentists.

Why is anyone still living in this country? Serious question since the pain, suffering & cost are so bad that economically it is stupid to be here.

All those places listed by WhyNot obviously are better places to live if you ever need medical help. The cost of living has to be better just because of the free medical, no co-pays, etc…

You all have me convinced. I wonder if the desire to immigrate will be enough if my only reason is for the free health care? Are they that nice?
In Germany
In Canada

OK, I get it, we are fools in the US. I guess I should have been born in Rwanda in 1943. I would be so much better off in your opinion. As long as I was a chronically sick person.

::: sheesh ::::

What makes you think Australia, Britain, Germany, or Canada are waiting for a bunch of sick Americans to move in?

When I posted to FB kvetching about the cost of an ER visit, and subsequent meds, one of my Canadian pals offered to marry me on the spot (he said I’d have to decorate the igloo when I moved in, but still).

But no, you can’t just move in to get free coverage. It won’t work that way, you know. You need to pay in via taxes to help pay for others, or the whole damn thing goes to hell. Or as same Canadian pal says, “When I need it, it’s there, so I don’t mind paying taxes out of my paycheque so others can get treatment.” That attitude is the main difference between countries with universal care and the US.

Frankly, I was born here, my whole family is here, and I’m a citizen. I love my country, and have no plans to leave. But understanding and discussing America’s flaws doesn’t negate one’s patriotism. If anything, those who recognize those faults, and who do what’s within their power to fix them, are far “better” patriots than those who brook no criticism. IMHO.

I picked “Other”. If I am using my insurance I do not discuss cost with the doctor. My insurance company has already negotiated and both have agreed to the rates. That’s their job. My job is to find the best doctor in their network for the care I need.

If I were paying out of pocket, you bet we’d have that discussion!